Adherence to CPAP treatment has been systematically examined without consistent findings that suggest predictors of or interventions to promote adherence. Preliminary findings reveal differences in adherence to CPAP, with African Americans having significantly lower adherence than non-African Americans, consistent with studies examining racial differences in adherence to medication where lower adherence in African Americans was contributed to by health beliefs, treatment perceptions, and self-efficacy. CPAP adherence in African Americans may be contributed to by specific health beliefs, diagnosis/treatment perceptions, and self-efficacy. A mixed methods study is proposed to examine the specific aims: (1) to describe pretreatment beliefs and perceptions about OSA and CPAP and the associated risks in African Americans with OSA as related to subsequent adherence to CPAP; (2) to describe beliefs and perceptions of African American CPAP-users after one week of treatment, including perceived effects of CPAP and how beliefs/perceptions influence adaptation to CPAP and adherence. Future randomized clinical trials of tailored intervention strategies to improve CPAP adherence and treatment outcomes in African Americans may be informed. [unreadable] [unreadable]